CMS Announces New Unified Program Integrity Contractors

CMS recently announced plans to implement a new Medicare and Medicaid program integrity contractor, Unified Program Integrity Contractors (UPICs). According to a request for information (RFI) released by CMS, the implementation of the UPICs is designed to “integrate the program integrity functions for audits and investigations across Medicare and Medicaid, and to ensure that [the Center for Program Integrity’s] national priorities for both Medicare and Medicaid are executed and supported locally.”

CMS further explained that “the scope of the UPICs will encompass functions that are currently performed by several contractors,” including: Zone Program Integrity Contractors (ZPICs), including their Medicare-Medicaid Data Match (Medi-Medi) responsibilities; Program Safeguard Contractors (PSCs);, and the Medicaid Integrity Contractors (MICs). UPICs will operate based on regional jurisdictions, with a single contractor conducting Medicare and Medicaid program integrity audits and investigations.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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